I literally stared at the word "cul-de-sac" for like 30 seconds and thought to myself - WTF is that? Then promptly missed the question.
P.S. it's the pouch of Douglas (rectouterine pouch).
Ascites & adnexal mass >> Follow adnexal mass workup Even if you follow ascites protocol - ans is diagnostic paracentesis, not therapeutic.
So here you do USG + CA 125 There can be 4 combination -
High Risk USG + Elevated CA125. Worst scene >>Imaging with CT/MRI Exploratory LAP
High Risk USG + Normal CA125. intermediate scene. Also do same as prev. We trust USG more.
Low Risk USG + Elevated CA125. Intermediate scene. But here do only imaging. CA 125 is less trustable.
Low Risk USG feature + Normal CA 125. Best scene. U do further imaging and CA 125 serially to monitor.
Unless there is a contraindication because of the ascites, it would be an exploratory laparoscopy not a laparotomy. I took flak on GYN-Onc for saying the wrong one
so you just open a b__ up without any other workup whatsoever? stupid question
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